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Block 5 > Asthma drugs > Flashcards

Asthma drugs Flashcards

1
Q

Th2 high asthmatics

A

respond to normal treatment

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2
Q

Th2 low asthmatics

A

neutrophilic inflammation
IL17 = glucocorticoid insensitivity
more airway remodeling

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3
Q

albuterol

A

SABA

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4
Q

levoalbuterol

A

SABA

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5
Q

terburtaline

A

SABA

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6
Q

metaproternol

A

SABA

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7
Q

bitolerol

A

SABA

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8
Q

salmeterol

A

LABA

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9
Q

formoterol

A

LABA

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10
Q

indacaterol

A

LABA

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11
Q

vilanterol

A

LABA

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12
Q

beta agonist moa

A

increase cAMP which leads to smooth muscle relaxation and blockage of mast cell degranulation

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13
Q

beta agonist use

A

short term bronchospasm release
emergency (SABA, epinephrine)
prophylaxis of exercise induced

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14
Q

first line rescue

A

SABA

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15
Q

beta agonist ADR

A

nonselective- tachycardia, hypotension, palpitations

tremors

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16
Q

methyl xanthines

A

theophylline

aminophylline

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17
Q

methy xanthine moa

A 
unknown
inhibit cAMP breakdown by blocking PDE
block adenosine receptors
inhibit NFkB
increase histone deacetylase activity
anti-inflammatory
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18
Q

theophylline use

A

not first line- use if unresponsive to first line

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19
Q

theophylline adr

A 
unpredictable plasma levels
liver metabolized
narrow TI
headache
nausea
arrythmias
seizures
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20
Q

anticholinergics

A

ipratropium

tiotropium

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21
Q

ipratropium

A

sama

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22
Q

tiotropium

A

lama

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23
Q

anticholinergic use

A

second line- not as good as beta2 agonists
used in combo with beta2
slower onset, last longer

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24
Q

anticholinergic moa

A

blocks muscarinic receptors to decrease broncoconstriction and mucus secretion

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25
Q

works with increased vagal tone

A

ipratropium

tiotropium

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26
Q

anticholinergic adr

A

dry mouth

cough

27
Q

fastest acting drug

28
Q

anti-inflammatory use

A

blocks late phase response

used in status asthmatics but does NOT relieve acute symptoms

29
Q

fluticasone

A

inhaled glucocorticoid

30
Q

beclomethasone

A

inhaled glucocorticoid

31
Q

flunisolide

A

inhaled glucocorticoid

32
Q

triamclinolone

A

inhaled glucocorticoid

33
Q

budesonide

A

inhaled glucocorticoid

34
Q

ciclesonide

A

inhaled glucocorticoid

35
Q

mometasone

A

inhaled glucocorticoid

36
Q

hydrocortisone

A

oral glucocorticoid

37
Q

predisone

A

oral glucocorticoid

38
Q

prednisolone

A

oral glucocorticoid

39
Q

methylprednisolone

A

oral glucocorticoid

40
Q

trimcloline

A

oral glucocorticoid

41
Q

glucocorticoid moa

A

blocks cytokine transcription
blocks down regulation of beta receptors
inhibits late phase response
long term use- blocks immediate response

42
Q

glucocorticoid use

A

first line prophylactic
inhaled
slow to act

43
Q

which drug class can patients be resistant to

A

glucocorticoids

44
Q

inhaled glucocorticoid adr

A

oral candidiasis
hoarseness
growth retardation

45
Q

systemic glucocorticoid adr

A 
osteoporosis
weight gain
hypertension
diabetes
myopathy
psych issues
46
Q

what class is commonly given in combo with LABA

A

glucocorticoid

47
Q

cromones

A

cromolyn sodium

nedocromil sodium

48
Q

cromone moa

A

unknown
prevents mediator release which inhibits immediate response
prevents late response

49
Q

cromone use

A

second line prophylaxis
inahled
not as good as steroids BUT lacks steroid side effects

50
Q

cromone adr

51
Q

leukotriene receptor antagonists

A

zafirlukast

montelukast

52
Q

leukotriene receptor antagonist moa

A

blocks CysLT1 receptor and prevents LTC4, LTD4, LTE4 effects

53
Q

leukotriene modifier use

A

first or second alternative for inhaled steroids

54
Q

leukotriene modifier adr

A

Churg Straus syndrome- remove glucocorticoids and get necrotizing vasculitis, skin rash, pulmonary inflammation, eosinophilia, heart failure

55
Q

5’ lipoxygenase inhibitor

56
Q

zileuton MOA

A

blocks leukotriene formation and action of LTB4

57
Q

omalzumab MOA

A

IgE inhibitor- anti IgE anibody

inhibits mast cell degranulation

58
Q

omalzumab use

A

first line in atopic patients not controlled by steroids or LABA

59
Q

anti IL5 antibodies

A

mepolizumab

resilzumab

60
Q

order of drug use

A 
SABA
low dose inhaled glucocorticoid
LABA added
increase steroid dose
add other drugs depending on phenotype
61
Q

emergency

A

inhaled saba
epinepherine
conventional steroids
theophylline and ipratropium

62
Q

drugs not to give to asthmatics

A

aspirin, NSAIDs

non selective beta blockers

63
Q

COPD drugs

A

same as for asthma
glucocorticoids are not as effective
mucolytics (acetylcysteine)

64
Q

roflumilast

A

PDE4 inhibitor for severe COPD

Block 5 (27 decks)

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